OCCASIONS FOR MULTIPLE FLAPS IN LOWER-LIMB RECONSTRUCTIONS - ONCE IS SOMETIMES NOT ENOUGH

A retrospective review of 11 patients with complex and massive lower-l imb defects requiring multiple transfers and/or regional muscle flaps for closure, found that microvascular transfers achieved final wound c losure, either alone or in concert with local flaps, in ail but one ca se. A local flap alone was not sufficient for any failed transfer reco nstruction. This suggested that transfers are not only the best initia l approach for massive lower-extremity defects, but they are sometimes the only solution available in complex lower-limb reconstruction, oft en when other options have failed.